82 FR 8568 - Agency Information Collection Activity: Shoulder and Arm Conditions Disability Benefits Questionnaire (VA Form 21-0960M-12)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 16 (January 26, 2017)

Page Range		8568-8568
FR Document		2017-01751

The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed revision of a currently approved collection, and allow 60 days for public comment in response to the notice. VA Forms 21-0960M-12 is used to gather necessary information from a claimant's treating physician regarding the results of medical examinations.

Federal Register, Volume 82 Issue 16 (Thursday, January 26, 2017)

[Federal Register Volume 82, Number 16 (Thursday, January 26, 2017)]
[Notices]
[Page 8568]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-01751]


-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0802]


Agency Information Collection Activity: Shoulder and Arm 
Conditions Disability Benefits Questionnaire (VA Form 21-0960M-12)

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Veterans Benefits Administration (VBA), Department of 
Veterans Affairs (VA), is announcing an opportunity for public comment 
on the proposed collection of certain information by the agency. Under 
the Paperwork Reduction Act (PRA) of 1995, Federal agencies are 
required to publish notice in the Federal Register concerning each 
proposed collection of information, including each proposed revision of 
a currently approved collection, and allow 60 days for public comment 
in response to the notice.
    VA Forms 21-0960M-12 is used to gather necessary information from a 
claimant's treating physician regarding the results of medical 
examinations.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 27, 2017.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email to [email protected]. Please refer to ``OMB Control 
No. 2900-0802'' in any correspondence. During the comment period, 
comments may be viewed online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632-8924 
or FAX (202) 632-8925.

SUPPLEMENTARY INFORMATION: 
    Under the PRA of 1995 (Public Law 104-13; 44 U.S.C. 3501-21), 
Federal agencies must obtain approval from the Office of Management and 
Budget (OMB) for each collection of information they conduct or 
sponsor. This request for comment is being made pursuant to Section 
3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VBA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VBA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VBA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Title: (Shoulder and Arm Conditions Disability Benefits 
Questionnaire (VA Form 21-0960M-12).
    OMB Control Number: 2900-0802.
    Type of Review: Extension of an approved collection.
    Abstract: VA Forms 21-0960M-12 is used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 25,000 hours.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 50,000 per year.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-01751 Filed 1-25-17; 8:45 am]
 BILLING CODE 8320-01-P

8568 Federal Register / Vol. 82, No. 16 / Thursday, January 26, 2017 / Notices

agreements meet the statutory period, comments may be viewed online DEPARTMENT OF VETERANS
requirements for approval. through the FDMS. AFFAIRS
Affected Public: Individuals or
FOR FURTHER INFORMATION CONTACT: [OMB Control No. 2900–0576]
household or small businesses/other
small entities. Nancy J. Kessinger at (202) 632–8924 or
FAX (202) 632–8925. Agency Information Collection
Estimated Annual Burden: 19,535 Activity: Certification of Affirmation of
hours. SUPPLEMENTARY INFORMATION: Enrollment Agreement
Estimated Average Burden per Correspondence Course (VA Form 22–
Respondent: 75 minutes. Under the PRA of 1995 (Public Law
104–13; 44 U.S.C. 3501–21), Federal 1999c)
Frequency of Response: Once.
Estimated Number of Respondents: agencies must obtain approval from the AGENCY: Veterans Benefits
15,628. Office of Management and Budget Administration, Department of Veterans
(OMB) for each collection of Affairs.
By direction of the Secretary.
information they conduct or sponsor. ACTION: Notice.
Cynthia Harvey-Pryor,
This request for comment is being made
Agency Clearance Officer, Office of Privacy SUMMARY: The Veterans Benefits
pursuant to Section 3506(c)(2)(A) of the
and Records Management, Department of
PRA. Administration (VBA), Department of
Veterans Affairs.
With respect to the following Veterans Affairs (VA), is announcing an
[FR Doc. 2017–01748 Filed 1–25–17; 8:45 am]
opportunity for public comment on the
BILLING CODE 8320–01–P collection of information, VBA invites
proposed collection of certain
comments on: (1) Whether the proposed
information by the agency. Under the
collection of information is necessary Paperwork Reduction Act (PRA) of
DEPARTMENT OF VETERANS for the proper performance of VBA’s 1995, Federal agencies are required to
AFFAIRS functions, including whether the publish notice in the Federal Register
[OMB Control No. 2900–0802] information will have practical utility; concerning each proposed collection of
(2) the accuracy of VBA’s estimate of the information, including each proposed
Agency Information Collection burden of the proposed collection of revision of a currently approved
Activity: Shoulder and Arm Conditions information; (3) ways to enhance the collection, and allow 60 days for public
Disability Benefits Questionnaire (VA quality, utility, and clarity of the comment in response to the notice. This
Form 21–0960M–12) information to be collected; and (4) notice solicits comments on information
AGENCY: Veterans Benefits ways to minimize the burden of the needed to determine a claimant’s
Administration, Department of Veterans collection of information on entitlement to educational assistance.
Affairs. respondents, including through the use DATES: Written comments and
ACTION: Notice.
of automated collection techniques or recommendations on the proposed
the use of other forms of information collection of information should be
SUMMARY: The Veterans Benefits technology. received on or before March 27, 2017.
Administration (VBA), Department of Title: (Shoulder and Arm Conditions ADDRESSES: Submit written comments
Veterans Affairs (VA), is announcing an Disability Benefits Questionnaire (VA on the collection of information through
opportunity for public comment on the Form 21–0960M–12). Federal Docket Management System
proposed collection of certain (FDMS) at www.Regulations.gov or to
information by the agency. Under the OMB Control Number: 2900–0802. Nancy J. Kessinger, Veterans Benefits
Paperwork Reduction Act (PRA) of Type of Review: Extension of an Administration (20M33), Department of
1995, Federal agencies are required to approved collection. Veterans Affairs, 810 Vermont Avenue
publish notice in the Federal Register Abstract: VA Forms 21–0960M–12 is NW., Washington, DC 20420 or email to
concerning each proposed collection of used to gather necessary information nancy.kessinger@va.gov. Please refer to
information, including each proposed from a claimant’s treating physician ‘‘OMB Control No. 2900–0576’’ in any
revision of a currently approved correspondence. During the comment
regarding the results of medical
collection, and allow 60 days for public period, comments may be viewed online
examinations.
comment in response to the notice. through the FDMS.
VA Forms 21–0960M–12 is used to Affected Public: Individuals or FOR FURTHER INFORMATION CONTACT:
gather necessary information from a households. Nancy J. Kessinger at (202) 632–8924 or
claimant’s treating physician regarding Estimated Annual Burden: 25,000 FAX (202) 632–8925.
the results of medical examinations. hours. SUPPLEMENTARY INFORMATION: Under the
DATES: Written comments and PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
Estimated Average Burden per
recommendations on the proposed Respondent: 30 minutes. 3501–21), Federal agencies must obtain
collection of information should be approval from the Office of Management
received on or before March 27, 2017. Frequency of Response: One time.
and Budget (OMB) for each collection of
ADDRESSES: Submit written comments Estimated Number of Respondents: information they conduct or sponsor.
on the collection of information through 50,000 per year. This request for comment is being made
Federal Docket Management System By direction of the Secretary. pursuant to Section 3506(c)(2)(A) of the
(FDMS) at www.Regulations.gov or to PRA.
jstallworth on DSK7TPTVN1PROD with NOTICES

Cynthia Harvey-Pryor,
Nancy J. Kessinger, Veterans Benefits With respect to the following
Administration (20M33), Department of Department Clearance Officer, Office of collection of information, VBA invites
Veterans Affairs, 810 Vermont Avenue Privacy and Records Management, comments on: (1) Whether the proposed
Department of Veterans Affairs.
NW., Washington, DC 20420 or email to collection of information is necessary
[FR Doc. 2017–01751 Filed 1–25–17; 8:45 am]
nancy.kessinger@va.gov. Please refer to for the proper performance of VBA’s
‘‘OMB Control No. 2900–0802’’ in any BILLING CODE 8320–01–P functions, including whether the
correspondence. During the comment information will have practical utility;

VerDate Sep<11>2014 15:10 Jan 25, 2017 Jkt 241001 PO 00000 Frm 00066 Fmt 4703 Sfmt 4703 E:\FR\FM\26JAN1.SGM 26JAN1

Document Created: 2017-01-26 00:05:16
Document Modified: 2017-01-26 00:05:16

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Written comments and recommendations on the proposed collection of information should be received on or before March 27, 2017.
Contact		Nancy J. Kessinger at (202) 632-8924 or FAX (202) 632-8925.
FR Citation		82 FR 8568